Aortic regurgitation echocardiography: Difference between revisions
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==ACC/AHA Guidelines- Echocardiography | ==ACC/AHA Guidelines- Echocardiography in Aortic Insufficiency (DO NOT EDIT) <ref name="pmid18848134">{{cite journal| author=Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD et al.| title=2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 13 | pages= e1-142 | pmid=18848134 | doi=10.1016/j.jacc.2008.05.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18848134 }} </ref>== | ||
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'''5.''' Radionuclide angiography or magnetic resonance imaging is indicated for the initial and serial assessment of LV volume and function at rest in patients with AR and suboptimal echocardiograms. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]]) | '''5.''' Radionuclide angiography or magnetic resonance imaging is indicated for the initial and serial assessment of LV volume and function at rest in patients with AR and suboptimal echocardiograms. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]]) | ||
'''6.''' Echocardiography is indicated to re-evaluate mild, moderate, or severe AR in patients with new or changing symptoms. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]]) | '''6.''' Echocardiography is indicated to re-evaluate mild, moderate, or severe AR in patients with new or changing symptoms. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]]) | ||
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]=== | ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]=== | ||
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===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]=== | ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]=== | ||
'''1.''' Exercise stress testing in patients with radionuclide angiography may be considered for assessment of LV function in asymptomatic or symptomatic patients with chronic AR. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]]) | '''1.''' Exercise stress testing in patients with radionuclide angiography may be considered for assessment of LV function in asymptomatic or symptomatic patients with chronic AR. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])}} | ||
==References== | ==References== | ||
Revision as of 20:22, 29 January 2012
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Aortic Regurgitation Microchapters |
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Diagnosis |
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Treatment |
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Acute Aortic regurgitation |
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Chronic Aortic regurgitation |
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Special Scenarios |
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Case Studies |
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Aortic regurgitation echocardiography On the Web |
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American Roentgen Ray Society Images of Aortic regurgitation echocardiography |
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Risk calculators and risk factors for Aortic regurgitation echocardiography |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Varun Kumar, M.B.B.S., Lakshmi Gopalakrishnan, M.B.B.S., Mohammed A. Sbeih, M.D. [3]
Overview
The most common test used for the evaluation of the severity of aortic insufficiency is the echocardiogram, which can provide two-dimensional views of the regurgitant jet, and allow measurement of the velocity and volume of the jet.
Echocardiographic Findings in Severe Aortic Insufficiency
The echocardiographic findings in severe aortic regurgitation include:
- An AI color jet dimension > 60 percent of the left ventricular outflow tract (LVOT) diameter (may not be true if the jet is eccentric)
- The pressure half-time of the regurgitant jet is < 250 msec
- Early termination of the mitral inflow (due to increase in LV pressure due to the AI.)
- Early diastolic flow reversal in the descending aorta.
- Regurgitant volume > 60 ml
- Regurgitant fraction > 55 percent
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- Increased duration between E and A peaks
- Fluttering of the anterior mitral valve leaflet due to AI jet turbulence
- Clinical setting to decide mechanism
Severe aortic insufficiency 1
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Severe aortic insufficiency 2
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Severe aortic insufficiency 3
Severe acute aortic insufficiency is considered a medical emergency. There is a high mortality rate if the individual does not undergo immediate surgery for aortic valve replacement. If the acute AI is due to aortic valve endocarditis, there is a risk that the new valve may become seeded with bacteria. However, this risk is small. [2]
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ACC/AHA Guidelines- Echocardiography in Aortic Insufficiency (DO NOT EDIT) [3]
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Class I1. Echocardiography is indicated to confirm the presence and severity of acute or chronic AR. (Level of Evidence: B) 2. Echocardiography is indicated for diagnosis and assessment of the cause of chronic AR (including valve morphology and aortic root size and morphology) and for assessment of LV hypertrophy, dimension (or volume), and systolic function. (Level of Evidence: B) 3. Echocardiography is indicated in patients with an enlarged aortic root to assess regurgitation and the severity of aortic dilatation. (Level of Evidence: B) 4. Echocardiography is indicated for the periodic re-evaluation of LV size and function in asymptomatic patients with severe AR. (Level of Evidence: B) 5. Radionuclide angiography or magnetic resonance imaging is indicated for the initial and serial assessment of LV volume and function at rest in patients with AR and suboptimal echocardiograms. (Level of Evidence: B) 6. Echocardiography is indicated to re-evaluate mild, moderate, or severe AR in patients with new or changing symptoms. (Level of Evidence: B) Class IIa1. Exercise stress testing for chronic AR is reasonable for assessment of functional capacity and symptomatic response in patients with a history of equivocal symptoms. (Level of Evidence: B) 2. Exercise stress testing for patients with chronic AR is reasonable for the evaluation of symptoms and functional capacity before participation in athletic activities. (Level of Evidence: C) 3. Magnetic resonance imaging is reasonable for the estimation of AR severity in patients with unsatisfactory echocardiograms. (Level of Evidence: B) Class IIb1. Exercise stress testing in patients with radionuclide angiography may be considered for assessment of LV function in asymptomatic or symptomatic patients with chronic AR. (Level of Evidence: B) |
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References
- ↑ Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA, Nihoyannopoulos P, Otto CM, Quinones MA, Rakowski H, Stewart WJ, Waggoner A, Weissman NJ (2003). "Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography". Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 16 (7): 777–802. doi:10.1016/S0894-7317(03)00335-3. PMID 12835667. Retrieved 2011-03-02. Unknown parameter
|month=ignored (help) - ↑ al Jubair K, al Fagih MR, Ashmeg A, Belhaj M, Sawyer W (1992). "Cardiac operations during active endocarditis". J. Thorac. Cardiovasc. Surg. 104 (2): 487–90. PMID 1495315.
- ↑ Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD; et al. (2008). "2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (13): e1–142. doi:10.1016/j.jacc.2008.05.007. PMID 18848134.